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Enlarge ImageRequest to buy this photoHector GabinoEl Nuevo HeraldDr. Steven Vanni operated on Jorge Valdez after the gymnast's body was cooled to 92.3 degrees to reduce swelling and inflammation.

Doctors cool gymnast’s body to treat severe spinal-cord injury -

MIAMI — A double flip gone wrong sent a 20-year-old state-champion gymnast to the hospital recently with a bilateral dislocation
of two vertebrae.

Jorge Valdez had attempted the double flip at a gym near South Miami-Dade, Fla., while practicing for tryouts for a Las Vegas
Cirque du Soleil production. During his routine, he landed squarely on his head.

The resulting spinal-cord injury led to nearly complete motor and sensory failure, doctors said — no movement in his legs
or hands, and minimal arm movement.

Valdez was flown to the Ryder Trauma Center at Jackson Memorial Hospital in Miami, and the prognosis wasn’t great. Initially,
doctors were not sure whether he would walk again, let alone return to gymnastics.

Two weeks later, Valdez walked out of the hospital, ready to resume practice. Also remarkable, he won’t need rehabilitation,
his doctors say.

Valdez’s unusual outcome is credited to hypothermic treatment, a relatively new procedure that uses cold for victims of severe
trauma to reduce swelling and inflammation. Dr. Steven Vanni of the Department of Neurological Surgery at the University of
Miami Miller School of Medicine performed the procedure.

Valdez “was the perfect storm for this type of injury to happen here,” Vanni said recently.

“We were able to immediately take him to the operating room and get his neck decompressed and fix the dislocation. No. 2,
we immediately started him on a hypothermia protocol to cool his body down to 33.5 degrees centigrade.”

That’s 92.3 degrees Fahrenheit. The average normal temperature of the human body is 98.6 degrees Fahrenheit.

That cooling process reduces the amount of swelling and inflammation on the spinal cord to help prevent further damage. That’s
important because the spinal cord exists in a closed environment. Unlike a facial injury such as a black eye, where there
is room to swell, the tight quarters combined with swelling cause more damage to the spinal cord and can lead to paralysis.

Valdez’s bilateral dislocation, in which the arms and legs are affected, are usually complete injuries, Vanni said.

“Most patients don’t make a functional recovery, and he just walked out of the hospital,” he said.

The surgery took about two hours. But Valdez was kept cooled for 48 hours after the injury and then slowly warmed before surgery.

The chilling is not unlike cases in which people who suffer near-drowning revive even after long periods underwater. The cold
slows the body’s metabolism which, in turn, slows the damaging inflammatory process.

The use of hypothermia to treat patients who have suffered severe injuries to the heart, brain or spinal cord gained traction
about five years ago when the American Heart Association recommended inducing hypothermia in some patients who had cardiac
arrest. Doctors at Jackson Memorial soon adopted the recommendations.

Manny Gomez, a Miami police officer thrown from his horse during a parade, was the first south Florida spinal-cord trauma
patient to be treated with hypothermia by Vanni at Jackson, in 2006. As with Valdez, doctors lowered Gomez’s body temperature
by several degrees for two days after he was injured.

“He had a great recovery,” Vanni said.

But Vanni added that hypothermia treatment is not a cure for everybody with a spinal injury, and there are risks.

“If you sever or cut the spinal cord, hypothermia is not going to fix it — nothing, yet, is going to fix it. If you bruise
it badly, it can help.”

In addition, the procedure’s risk factors include pneumonia and blood clots.

Despite the severity of his injury, Valdez didn’t have other injuries that would have complicated the procedure. Vanni was
able to isolate the spinal cord, and the treatment worked.